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Int. J. Environ. Res. Public Health 2015, 12, 6319-6332; doi:10.

3390/ijerph120606319
OPEN ACCESS

International Journal of
Environmental Research and
Public Health
ISSN 1660-4601
www.mdpi.com/journal/ijerph
Article

An Evaluation of Antifungal Agents for the Treatment of


Fungal Contamination in Indoor Air Environments
Senthaamarai Rogawansamy 1,, Sharyn Gaskin 1,,*, Michael Taylor 1,2 and
Dino Pisaniello 1
1

Occupational and Environmental Hygiene Laboratory, Discipline of Public Health, School of


Population Health, University of Adelaide, South Australia 5005, Australia;
E-Mails: Sentha.Rogawansamy@unisa.edu.au (S.R.); michael.taylor@flinders.edu.au (M.T.);
dino.pisaniello@adelaide.edu.au (D.P.)
Health and Environment, School of the Environment, Flinders University, South Australia
5042, Australia
These authors contributed equally to this work.

* Author to whom correspondence should be addressed; E-Mail: sharyn.gaskin@adelaide.edu.au;


Tel.: +61-883-134-957; Fax: +61-883-134-955.
Academic Editors: William A. Toscano and Paul B. Tchounwou
Received: 20 April 2015 / Accepted: 27 May 2015 / Published: 2 June 2015

Abstract: Fungal contamination in indoor environments has been associated with adverse
health effects for the inhabitants. Remediation of fungal contamination requires removal of
the fungi present and modifying the indoor environment to become less favourable to
growth. This may include treatment of indoor environments with an antifungal agent to
prevent future growth. However there are limited published data or advice on chemical
agents suitable for indoor fungal remediation. The aim of this study was to assess the
relative efficacies of five commercially available cleaning agents with published or
anecdotal use for indoor fungal remediation. The five agents included two common
multi-purpose industrial disinfectants (Cavicide and Virkon), 70% ethanol, vinegar
(4.0%4.2% acetic acid), and a plant-derived compound (tea tree (Melaleuca alternifolia)
oil) tested in both a liquid and vapour form. Tea tree oil has recently generated interest for
its antimicrobial efficacy in clinical settings, but has not been widely employed for fungal
remediation. Each antifungal agent was assessed for fungal growth inhibition using a disc

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diffusion method against a representative species from two common fungal genera,
(Aspergillus fumigatus and Penicillium chrysogenum), which were isolated from air
samples and are commonly found in indoor air. Tea tree oil demonstrated the greatest
inhibitory effect on the growth of both fungi, applied in either a liquid or vapour form.
Cavicide and Virkon demonstrated similar, although less, growth inhibition of both
genera. Vinegar (4.0%4.2% acetic acid) was found to only inhibit the growth of
P. chrysogenum, while 70% ethanol was found to have no inhibitory effect on the growth of
either fungi. There was a notable inhibition in sporulation, distinct from growth inhibition
after exposure to tea tree oil, Virkon, Cavicide and vinegar. Results demonstrate that
common cleaning and antifungal agents differ in their capacity to inhibit the growth of
fungal genera found in the indoor air environment. The results indicate that tea tree oil was
the most effective antifungal agent tested, and may have industrial application for the
remediation of fungal contamination in residential and occupational buildings.
Keywords: Airborne fungi; indoor air quality (IAQ); vinegar; tea tree oil; inhibition zone

1. Introduction
Populations in developed countries spend more than 90% of their time indoors and the installation
and maintenance of HVAC (heating, ventilating, and air conditioning) systems has become
increasingly important. Fungal spores are common components of both indoor and outdoor air.
However, fungi have become one of the leading causes of indoor air quality (IAQ) complaints in
occupational settings [13]. Fungi are now frequently implicated as a causative agent in sick building
syndrome [4] and fungal contamination of indoor environments has been linked to adverse health
effects including headache, allergy, asthma, irritant effects, respiratory problems, mycoses (fungal
diseases), and several other non-specific health problems [5]. More than 80 genera of fungi have been
associated with symptoms of respiratory tract allergies with Cladosporium, Alternaria, Aspergillus and
Penicillium amongst the most common allergenic genera [6]. Beyond allergenicity, many fungi
produce microbial volatile organic compounds (MVOCs) and mycotoxins that are believed to irritate
the respiratory system. Research from animal studies and data from occupational settings have shown
that exposure to mycotoxins can result in mucus membrane irritation, skin rashes, dizziness, nausea,
and immunosuppression [7].
Fungi are able to grow in indoor environments where there is sufficient moisture and a nutrition
source, such as wood, paint and insulation and release spores as part of their reproductive process [8].
Both temperature and water availability affect growth and sporulation characteristics of airborne fungi,
with higher ambient temperatures and available water favouring faster growth. Release of spores is
subsequently increased by intermittent periods of dryness where spores are dispersed, and moisture
allowing for further growth and sporulation. Fungal species found indoors usually reflect those in the
outdoor environment, although concentrations may change seasonally or locally where the indoor
environment is favourable to the growth of particular species [3]. The most common genera are
saprophytes, including those living on decaying plant material, Cladosporium, Alternaria, Epicoccum

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and Aureobasidium, while soil-based species, such as Aspergillus and Penicillium, are relatively low in
number in outdoor air but are found at increased levels indoors [9]. Aspergillus sp. and Penicillium sp.
have been recognized as significant indoor air allergens [10]. Fungi typically enter a building through
heating, air conditioning and ventilation systems, windows, doors, and as contaminants on building
materials. Prolonged high moisture levels in a building then provide the necessary conditions for fungal
growth and sporulation to occur and mechanical disturbances can cause the spores to become airborne.
In Australia, there are currently no indoor air quality guidelines for fungi in air. However, there are
a number of international guidelines available, both current and historic (as outlined in [3]) but
typically World Health Organization guidelines are adopted [11]. As the relations between dampness,
microbial exposure and health effects cannot be quantified precisely, no quantitative health-based
guideline values or thresholds can be recommended for acceptable levels of contamination with
microorganisms [11]. Instead, it is recommended that dampness and mould related problems be
prevented and rapidly remediated when they occur to reduce the risk of hazardous exposure to
microbes and chemicals. Other considerations include the relationship between indoor and outdoor
levels as represented by simultaneously collected samples. The principle is that lower indoor than
outdoor fungal levels indicate an acceptable indoor environment and the diversity of indoor fungal
genera should be similar to that found outdoors [3,5].
To minimise the potential for exposure, it is essential to remediate an indoor space with visible
fungal contamination. The remedial process involves the removal of visibly contaminated building
material and the use of an antifungal product to treat surfaces, in conjunction with steps to modify the
indoor environment to prevent future fungal growth [12]. The use of a HEPA vacuum cleaner is
recommended in combination with damp wiping non-porous surfaces to remove the dispersed
spores in buildings [13].
An antifungal agent, or fungicide, is a biocidal chemical compound or biological organism used to
kill or inhibit fungi or fungal spores. The Australian Mould Guideline [14] is commonly adopted by
industry and recommends damp wiping with a detergent, vinegar solution or alcohol solution for
removing fungi from contaminated surfaces. It also lists antifungal agents such as bleach, alcohol
(100%), quaternary ammonium compounds and formaldehyde as chemicals that are used in the
treatment of fungi on surfaces but does not explicitly recommend the use of these agents for preventing
future growth.
Fungicides perceived to be of natural origin are being investigated increasingly for use in fungal
contamination remediation. Vinegar (acetic acid) is reported to have an antimicrobial effect on fungi in
various applications. Vinegar vapour application has been demonstrated to prevent the germination of
conidia of fruit decay fungi Penicillium expansum, Monilinia fructicola and Botrytis cinerea in
strawberries, apples, and stone fruit [15] and Colletotrichum coccodes in tomato fruit [16]. Vinegar in
water, in an undefined concentration, has been recommended by the Australian Mould Guidelines [14],
for damp wiping hard surfaces in the remediation of an indoor fungal contamination. There is also
growing interest in the antimicrobial efficacy of compounds such as essential oils. Tea tree oil (TTO)
is purported to be a plant-derived antifungal agent that utilises the same mechanism of toxicity in fungi
as 70% ethanol and vinegar, by killing the conidia and preventing germination of the spores [17,18].
There are some studies investigating the antifungal efficacy of TTO in the clinical setting: TTO has
been used in the treatment of fungal infections such as vaginal and oral candidiasis and has shown

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strong antiviral activity on the Influenza A virus and E.coli Phage M13 Phage [19]. Tea tree oil has not
been widely considered for environmental application beyond agricultural use, and there is limited
information on its use in indoor fungal contamination [12,20].
The aim of this study was to assess the relative efficacies of five commercially available cleaning agents
with published or anecdotal use for indoor fungal remediation. The five agents included two common
multi-purpose industrial disinfectants (Cavicide and Virkon), 70% ethanol, vinegar (4.0%4.2% acetic
acid), and a plant-derived compound (tea tree (Melaleuca alternifolia) oil).
2. Experimental Section
2.1. Antifungal Agent Selection
The antifungal agents used in this study are commercially available and commonly used products.
Virkon and Cavicide are broad spectrum disinfectants currently used to sanitise surfaces and
equipment in the medical and healthcare sector. Virkon (Antec International Limited) is the brand
name for a disinfectant containing peroxygenic acid (50% potassium monoperoxysulphate, potassium
hydrogen sulphate and potassium sulphate) and is applied at a concentration of 1% for 10 min and
claims to kill bacteria, viruses, fungi and spores. However, there is limited published information on
Virkons capacity to kill fungi and spores. For this study, Virkon was prepared at a range of test
concentrations: 10%, 5%, 3% and 1%. Cavicide (17.2% Isopropyl Alcohol, 0.28% Benzethonium
Chloride; Bacto Laboratories Pty Ltd) is a broad spectrum disinfectant used undiluted for the cleaning
of hard surfaces of medical and dental devices and claims to have bactericidal, virucidal, fungicidal
and tuberculocidal properties. Cavicide was assessed undiluted and at a concentration of 75%.
Tea tree oil (100% Melaleuca alternifolia oil; Bosistos Pty Ltd) is commonly used as a natural
topical antiseptic and also as a complementary medicine for fungal infections. Tea tree oil was tested
both as a direct contact solution and in vapour phase given evidence in clinical settings of its potential
antifungal effects in both forms, and growing interest in the antimicrobial effects of this natural
product [12,17,18]. Vinegar (4.0%4.2% acetic acid) and 70% ethanol were also chosen due to their
common recommendation in fungal remediation and anecdotal support in disinfection of hard surfaces.
2.2. Environmental Fungi Sampling and Identification
Environmental air samples were collected onto malt extract agar (MEA) plates using a BioStage
single-stage viable cascade impactor, attached to a SKC QuickTake 30 Air sampler. Air samples
were collected for 2 min each at a flowrate of 28.3 L/min [21]. Agar plates were incubated for 7 days
at 25 C. After 7 days, fungal colonies were tape lifted onto glass slides and stained with lactophenol
cotton blue for 5 min before observation by phase contrast microscopy (Nikon Eclipse Ci; Coherent
Scientific). Two genera representing the most commonly isolated fungi from environmental samples
were selected for use in the study (an Aspergillus fumigatus from indoors, and Penicillium chrysogenum
from outdoors). The fungi selected for use in this study represent extremely common airborne fungi,
capable of growth on a wide range of substrates, and frequently isolated from indoor environments not
only in Australia but worldwide [22,23].

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To obtain pure cultures, three agar plugs 6 mm in diameter were cut from the edge of an individual
A. fumigatus colony using the end of a glass Pasteur pipette and aseptically transferred to a fresh MEA
plate and evenly placed apart. This was repeated for P. chrysogenum. The plates were wrapped in
parafilm and incubated at 25 C for 7 days and observed for the appearance of pure fungal colonies.
2.3. Antifungal Efficacy Using Disc Diffusion Assay
Fickers [24] disc diffusion assay was used to assess the inhibitory effect of antifungal agents on the
growth of A. fumigatus and P. chrysogenum. Spore suspensions were prepared by flooding fungal
culture plates with 3 mL of sterile distilled water and a sterile loop was used to agitate colonies.
One hundred microlitres of each spore suspension was used to inoculate MEA plates which were left to
dry at room temperature for 15 min. Inoculated MEA plates were sectioned into halves and 20 L of
each of the test agents were pipetted onto an autoclaved WhatmanTM filter paper disc 9 mm in diameter
and placed in the middle of each section.
Phenol (88% solution) was used as a positive control for fungal growth inhibition and sterile
distilled water was used as a negative control. Plates were sealed with parafilm and incubated at 25 C
for 7 days before observation for fungal growth and formation of inhibition zones around disks. Each
test was repeated a minimum of 3 times for each agent (additional replicates n = 46 were performed
where a positive result was found). An agent was categorised as having antifungal activity when the
diameter of the inhibition zone was larger than 9.5 mm, 0.5 mm larger than the diameter of the paper
disc [24]. This value serves as a frame of reference against which the antifungal susceptibility of the
fungi can be compared. The larger the concentric area of inhibited growth, the greater the efficacy of
the antifungal agent.
The antifungal activity of TTO in vapour phase was assessed using a modified method of [25].
A 100 L spore suspension of each fungal species was spread onto fresh MEA plates and allowed to
air dry for 15 min at room temperature. Twenty microliters of TTO was pipetted onto a 9 mm paper
disc and placed on the inner surface of the petri dish lid, having no direct contact with the surface of
the inoculated agar. Plates were rapidly sealed in parafilm to minimise escape of the volatile
components, then incubated at 25 C and observed after 7 and 14 days. Antifungal efficacy was
determined by measuring the mean perpendicular diameter of the inhibition zone. To examine the
growth inhibitory effect of TTO over time, the TTO vapour and solution disc assay plates for both
fungal genera were re-incubated for an additional seven days after initial treatment, bringing the total
incubation period to 14 days. Following re-incubation, the assay plates were re-measured for
growth inhibition.
2.4. Data Analysis
Comparisons of inhibition zones by antifungal agents and controls were performed using one-way
ANOVA. Assumption of data normality were checked and met for parametric analysis. Post-hoc
analysis was performed where required using Tukey Multiple Comparisons test. Significance for all
tests was set at p 0.05. Statistical analyses were performed using SPSS v.16 and GraphPad Prism
V.4 software.

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3. Results and Discussion


Tea tree oil applied as a direct contact solution was found to have the highest inhibitory effect on
the growth of both A. fumigatus and P. chrysogenum after a seven-day incubation period compared to
the other antifungal agents tested (Figure 1). A. fumigatus growth was completely inhibited by TTO
with a mean inhibition zone diameter (83 mm) significantly greater than other test compounds
(p < 0.0001, R2 = 0.9761) and comparable to the results of the positive control phenol. TTO was less
toxic to the P. chrysogenum (mean inhibition zone diameter of 43.5 mm 4.93), but more effective at
inhibiting growth than the other compounds tested (p < 0.001, R2 = 0.9620). TTO when applied in
vapour form, was found to be less effective than direct application in inhibiting the growth of
condidate fungi (A. fumigatus mean inhibition zone diameter of 81 mm 4; P. chrysogenum mean
inhibition zone diameter of 20.6 mm 12.85 for the vapour assay).
Virkon was only effective at reducing fungal growth at a concentration of 10%, demonstrating a
mean inhibition zone diameter of 19.25 mm ( 7.08) for A. fumigatus, and 18.67 mm ( 1.15) for
P. chrysogenum (Figure 1). Five percent, 3%, and 1% Virkon solutions had no effect on the growth of
either fungi.
Undiluted Cavicide was found to have a similar inhibitory effect on the growth of both fungi, with
a mean inhibition zone diameter of 16 mm ( 0) for both (Figure 1). In contrast, 75% Cavicide had no
inhibitory effect on the growth of either fungi.
Vinegar (4.0%4.2% acetic acid) had an inhibitory effect on the growth of P. chrysogenum with a
mean inhibition zone diameter of 15 mm ( 1.15), but did not show an inhibitory effect on the growth
of A. fumigatus (Figure 1). Seventy-percent ethanol had no visible effect on the growth of either
fungi (Figure 1).

Figure 1. Diameter of growth inhibition zones of Aspergillus fumigatus and


Penicillium chrysogenum after treatment using various antifungal agents. Mean SD
(N = 40).
For some test agents, although growth remained unaffected, inhibition of sporulation was noted.
Five percent, 3%, and 1% Virkon inhibited sporulation of P. chrysogenum, but had no visible effect
on the sporulation of A. fumigatus. Seventy-five percent Cavicide inhibited the sporulation of

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A. fumigatus but not P. chrysogenum. Vinegar suppressed sporulation of P. chrysogenum but had no
effect on the sporulation of A. fumigatus.
The potential longer-lasting growth inhibition effects of TTO on A. fumigatus and P. chrysogenum
are shown in Figure 2. TTO applied as a solution became less effective at inhibiting growth of
P. chrysogenum after 14 days of treatment (p = 0.004), but not so for A. fumigatus. TTO vapour
showed decreased growth inhibition as a function of time against both fungi, although only shown to
be significant for A. fumigatus (p = 0.0002). Sporulation was observed on day 14 of treatment on all
TTO exposed cultures.

Figure 2. Difference in growth inhibition zones of Aspergillus fumigatus and


Penicillium chrysogenum 7 and 14 days after initial treatment with tea tree oil. Mean SD
(N = 24).
The results of this study indicate that common cleaning and antifungal agents differ in their capacity
to inhibit the growth of common indoor fungal genera. In fact, strains within a species may behave
differently to biocides, as demonstrated by Tortorano et al. [26] for fifteen Aspergillus fumigatus
clinical isolates. The broad spectrum disinfectant Virkon did show evidence of antifungal activity
against both genera, but only at the highest test concentration (10%), which is ten times the
manufacturers recommended concentration for disinfecting surfaces. Five percent, 3%, and 1%
Virkon solutions had no effect on the growth of either fungi, a result which is corroborated by [27]
who assessed the in vitro efficacy of 1% Virkon against bacteria, fungi, viruses and spores.
Hernandez et al. [27] demonstrated bactericidal activity against both Gram-positive and Gram-negative
vegetative bacteria in 5 min, virucidal activity was shown against poliovirus and biocidal activity was
shown against C.albicans after 15 min. However, there was no fungicidal activity against
Penicillium verrucosum and Absidia corymbifera and Bacillus cereus spores even after 1 h of contact.
The authors concluded that 1% Virkon is a low level disinfectant as it has a rapid biocidal effect against
vegetative bacteria and viruses but is incapable of killing endospores and fungi within a reasonable
amount of time. Virkon was also found to be ineffective at disinfecting Mycobaterium tuberculosis at
both 1% and 3% concentrations on hospital instruments and surfaces [28]. Broadley et al. [29] reported
that at 2%, 3%, and 4% concentrations, Virkon was unable to provide a satisfactory kill of mycobacteria,

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but retarded the onset of growth, and was not recommended as a mycobactericidal agent. The chemical
composition of Virkon includes a stabilised blend of peroxy compounds, surfactant, organic acids and
an inorganic buffer system. Its mechanism of action is considered to be the denaturation of cellular
proteins through its high oxidizing activity [30]. Although Virkon at 10% concentration was shown to
be somewhat effective as an antifungal agent in the current study, it could pose potential hazards to
workers or occupants due to its corrosivity and toxicity at such a high concentration and would have
limited application in the indoor air environment.
Cavicide, another broad spectrum disinfectant, similarly demonstrated some antifungal activity
against both genera in the current study, but only when applied undiluted. No studies assessing the
antifungal activity of Cavicide have previously been reported. Some evidence for antibacterial
activity has been reported in the literature, for example it was effective in lowering Staphylococci
bacterial loads on bed rails in a hospital by up to 97% [31], which was attributed to its high alkaline
nature, but was found to be ineffective against Bacillus subtilis [32]. Cavicide is composed of
isopropanol and diisobutyl phenoxyethoxyethyl dimethyl benzyl ammonium chloride. It is used
undiluted in laboratories and hospitals for surface and instrument disinfection. It has been reported to
be 50% more effective in lowering the microbial load on patient bed rails in comparison to
disinfectants containing quaternary ammonium compounds [31], although within six hours of
application, the microbial load had exceeded acceptable levels, indicating that the frequency of
application is an important variable for maintaining low microbial loads [31]. The antimicrobial
efficacy of Cavicide may be associated with its high alcohol concentration in conjunction with a pH
of 12. As demonstrated for Virkon, it seems the application of Cavicide to the indoor air
environment has limited viability due its chemical composition, despite Cavicide being able to reduce
fungal growth at the recommended concentration in both genera.
The Australian Mould Guidelines [14] recommend the use of vinegar or alcohol for the removal of
mould from contaminated surfaces. However, this study demonstrates that vinegar has limited
antifungal action while ethanol (70%) is ineffective as an antifungal agent for the treatment of two
common fungal genera in the indoor air environment. Vinegar (4.0%4.2% acetic acid) was found to
inhibit the growth of P. chrysogenum but not A. fumigatus in the current study. Vinegar is a known
antimicrobial agent and there is some evidence to suggest that it possesses antifungal properties.
Sholberg et al. [15] found that vinegar vapour effectively inactivated the conidia of several decay fungi
on fruit due to its acetic acid content (5%), by lowering the pH of the cell protoplasm and killing the
conidia. In another study, bamboo vinegar was found to have a dose-dependent inhibitory effect on the
growth of bacteria and fungi due to its active compounds phenols, acetic acid and alcohols [33].
The use of vinegar as a fungal remediation agent may be warranted, however its lack of persistence on
surfaces may limit its use to removal of fungal contamination on non-porous materials and prevent
future growth. An important avenue of future work is to explicitly test the application of cleaning
agents to a range of surface materials. Agar is used in virtually all laboratory studies as a model for
many real world conditions, however it is not without limitations. Due to its high water content it may
exert some degree of dilution in highly water-soluble compounds. Similarly, chlorine based
disinfectants may be quenched by the organic content of the media. However, these effects are also
likely to be noted in building materials or other test matrices, and further characterisation of
compounds in real world conditions is warranted.

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Ethanol is widely used for general surface disinfecting and has reported biocidal efficacy against
bacteria, fungi and viruses in the concentration range of 50%90% [34]. In the current study, 70% was
found to be completely ineffective as an antifungal agent against common airborne fungal genera.
In contrast, in the food industry, ethanol has been shown to inhibit mould growth on bread, which is
usually spoiled by Penicillium, Aspergillus, and Cladosporium [35]. It has also been used to prevent
postharvest decay of fruits [15,36]. Ethanol vapour was found to inhibit germination of the fungal
conidia (Penicillium chrysogenum) isolated from pastry products, but this was found to be reversible
over time as some spores remained viable [37]. Ethanol interacts with cellular membranes increasing
membrane permeability and causing leakage of solutes and cell lysis. Higher concentrations of ethanol
are required to kill fungal spores than bacteria, which show a maximum kill efficacy of 70%
ethanol [34]. Dao et al. [38] found that ethanol as both a liquid and vapour could significantly inactivate
fungal spores (Penicillium chrysogenum, P. digitatum, and P. italicum) and recommended further
investigation into the use of ethanol vapour in place of ethanol solution to prevent mould growth
in workplaces.
Tea tree oil as a direct contact solution, was the most effective at inhibiting fungal growth of both
test species among all the agents assessed in the current study. This result is in agreement with
previously published data on the antimicrobial efficacy of TTO in vitro from a clinical setting [17,18].
The mechanism of TTOs antifungal action is believed to be by the alteration of the cell membrane
structure, causing it to become permeable, which leads to the leakage of cellular material and
disruption to cellular functions [39]. Hammer et al. [17] found that TTO had both an inhibitory effect
and a fungicidal effect on filamentous fungi. The authors found both germinated conidia and
non-germinated conidia of the fungal isolates demonstrated susceptibility to TTO. In the current study,
results show that P. chrysogenum is less susceptible to TTO than A. fumigatus. The reduced
susceptibility of different conidia to antifungal agents is possibly due to the thickness, composition and
density of the conidial wall.
Furthermore, tea tree oil was found to be more effective as a direct contact solution at inhibiting the
growth of A. fumigatus and P. chrysogenum, than in vapour phase. This challenges previous reports of
TTO in vapour phase having a greater inhibition effect than TTO in solution on fungal growth [40].
Shao et al. [41] also reported that TTO vapour displayed a greater inhibitory effect on fungal growth
than in direct contact. Soylu et al. [25] proposed that TTO vapour may be more readily absorbed by
fungal mycelium since it is not diluted by the water content of agar medium as per the direct contact
phase in solution. The main compounds reported to be responsible for the antimicrobial activity of
TTO are terpinen-4-ol and 1,8-cineole [41]. TTO was found to exhibit antifungal activity in contact
and vapour phase on the mycelial growth of B.cinerea by rupture of the cell wall and by increasing
membrane permeability [41]. Hammer et al. [17] found that TTO had both an inhibitory effect and a
fungicidal effect on filamentous fungi including Aspergillus niger, Aspergillus fumigatus and
Penicillium spp at Minimum Inhibitory Concentrations of 0.06%0.12% (v/v) and Minimum
Fungicidal Concentrations (MFC) of 2%8% (v/v). Both germinated conidia and non-germinated
conidia of the isolates demonstrated susceptibility to TTO. Time-kill assays showed that the duration
of exposure of the fungi to TTO could influence the fungicidal action. However, there is limited
information on TTO in indoor applications. Tea tree oil was the overall most effective antifungal agent
and could be explored for remediation of fungal contamination. Consideration should be given to any

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potential health effects for occupants from exposure to TTO by direct contact (dermal) with residue or
inhalation of vapour. TTO constituents may have skin sensitizing properties (e.g., limonene), although
scientific evidence regarding the inhalational health effects of these aromatic compounds remains
limited [17,42].
Suppression of sporulation as distinct from growth was a notable occurrence in the current study.
Sporulation inhibition is not typically reported in the literature as an antimicrobial effect, but may still
be considered a form of remediation as inhibition of spore formation would be expected to reduce the
ongoing inoculum potential and generation of allergenic particles from fungi. Carson et al. [18] and
Inouye et al. [43] reported the ability of TTO vapour to inhibit fungal growth and affect sporulation.
Inouye et al. [44] reported that TTO vapour could affect fungal sporulation by a direct absorbing effect
on aerial hyphae and demonstrated that sporulation inhibition was an effect of inhibition of respiration
rather than the inhibition of growth. Similarly, in a study of essential oil effects on fungal cultures,
some plates showed no growth inhibition whilst sporulation was completely inhibited with TTO [40],
demonstrating the greatest inhibitory effect on sporulation of the three compounds tested. While only
10% Virkon displayed a growth inhibition effect, all concentrations of Virkon were found to have
suppressed the sporulation of P. chrysogenum in the current study. Similarly, both test concentrations
of Cavicide were found to inhibit the sporulation of A. fumigatus. In contrast, vinegar was found to
only inhibit the growth and sporulation of P. chrysogenum Antifungal agents displaying inhibition of
sporulation with limited growth inhibition effect should not necessarily be discounted as effective
antifungal agents. Sporulation inhibition could provide an important benefit in fungal remediation by
reducing contamination persistence and by reducing the ongoing allergenicity of fungi present in
indoor environments.
There is limited published information more broadly on the use of antifungal agents in indoor
fungal contamination. Chakravarty and Kovar [12] tested five antifungal agents, Sanimaster, 17%
hydrogen peroxide, 70% isopropyl alcohol, bleach and Sporicidin used in indoor fungal remediation
by companies in the USA. They studied the inhibitory effects of growth and spore germination of six
fungal species commonly found indoors; Alternaria alternata, Aspergillus niger, Chaetomium globosum,
Cladosporium herbarum, Penicillium chrysogenum and Stachybotrys chartarum. The six species were
inoculated into pine wood blocks and incubated at 25 C. There was a significant inhibitory effect on
growth and spore germination exhibited by all five compounds tested within 12 h of treatment.
However, when the agents had been rinsed off with distilled water, the fungal spores recovered and
became viable after a 24-h incubation period. Two weeks after the treatment, fungal growth was found
to be entirely uninhibited. This reversible inhibitory effect is described as mycostasis, in which the
growth of the spores is inhibited by the antifungal compounds without any effect on viability.
The authors concluded that most antifungals are effective on hard non-porous surfaces but viable
spores within porous surfaces may be unaffected and become dormant when an antifungal is applied.
Huang et al. [20] found that TTO applied on the filter surface of a HVAC system inactivated
environmental fungal spores and prevented the re-entry of the dead spores back into the air by
adhesion. There could be potential for the use of TTO on HVAC filters to control bioaerosol
concentrations in occupational and residential settings and is classified as generally regarded as safe
(GRAS) by the United States Food and Drug Administration (FDA).

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A 2.4% sodium hypochlorite (NaOCl) treatment was tested on Alternaria alternate,


Aspergillus niger, Cladosporium herbarum, Penicillium chrysogenum, Stachybotrys chartarum and
Trichophyton mentagrophytes and found to inactivate all the spores of the stock cultures to
undetectable levels after 5 min contact time on non-porous surfaces and after 10 min contact time on
porous surfaces [45]. These results suggest that hypochlorite disinfectants are effective in the reduction
of fungal proliferation and allergen levels in the indoor environment. Sodium hypochlorite has also
been recommended for use in very low concentrations (0.04%) to inactivate fungi on grains, nuts and
vegetables [46].
This work broadly highlights the need for consistency in advice given for remediation of fungal
damage and the importance of verifying anecdotal evidence or common knowledge advice of
antifungal agents and cleaning procedures. Importantly, any adopted antifungal agent would need to be
implemented in conjunction with technical measures, such as improving ventilation and reducing
humidity in the indoor air to prevent future growth.
4. Conclusions
This study assessed the efficacy of different antifungal agents on two commonly found fungal
genera from the indoor air environment. Ideally, an effective antifungal agent would inhibit the growth
of a range of common fungal genera, whilst increasingly less effective antifungal agents would only
inhibit sporulation or inhibit the growth of a limited range of fungal genera. Some antifungal agents
assessed in this study completely inhibited growth while others had reduced or no visible effect.
The best performing agents were tea tree oil in liquid and vapour applications, undiluted Cavicide and
10% Virkon which were effective in inhibiting the growth of both genera. However, Cavicide and
10% Virkon may have limited viability for use in the indoor air environment due to their chemical
composition. Some agents were only effective against one species and not the other, such as vinegar,
which only inhibited the growth and sporulation of P. chrysogenum. The use of vinegar as an
antifungal agent may not be effective against the diverse fungal genera found in the indoor air
environment. Seventy percent ethanol had no inhibitory effect on either fungi and is not suggested as
an effective antifungal treatment. Some agents completely inhibited sporulation irrespective of
inhibition of growth. Sporulation-inhibiting agents should not be dismissed as antifungal agents as the
inhibition of sporulation may also be important for the control of fungal growth as spores are the main
mode of transport of fungal growth and are linked to respiratory symptoms in the indoor air
environment. Tea tree oil was the most effective antifungal agent tested, and may have industrial
application for the remediation of fungal contamination in residential and occupational buildings.
Further studies seem warranted to investigate the application of TTO and its growth inhibition efficacy
on a wider range of fungal genera found in the indoor air environment. Antifungal agents should also
be tested on contaminated surfaces, such as construction materials found within a building, to
determine their activity. This would enable effective antifungal agents to be prescribed for application
in indoor air quality control of residential and occupational buildings.

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Author Contributions
Sharyn Gaskin and Michael Taylor conceived and designed the study. Senthaamarai Rogawansamy
conducted the data collection, with the assistance of Sharyn Gaskin (air sampling for fungal isolates)
and Michael Taylor (fungal species identification). Sharyn Gaskin conducted the data analysis.
Senthaamarai Rogawansamy and Sharyn Gaskin drafted the manuscript, and Michael Taylor and
Dino Pisaniello revised the manuscript. All authors read and approved the final manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
References
1.

Fung, F.; Hughson, W.G. Health effects of indoor fungal bio aerosol exposure. Appl. Occup.
Environ. Hyg. 2003, 18, 535544.
2. Bird, C.; Balshaw, S.; Anderson, W. Getting the best answer by asking the right question-case
studies in occupational exposure to mould. J. Health Saf. Res. Practice 2012, 4, 1927.
3. Taylor, M.; Gaskin, S.; Bentham, R.; Pisaniello, D. Airborne fungal profiles in office buildings in
metropolitan Adelaide, South Australia: Background levels, diversity and seasonal variation.
Indoor Built Environ. 2013, 23, 10021011.
4. Cooley, J.D.; Wong, W.C.; Jumper, C.A.; Straus, D.C. Correlation between the prevalence of
certain fungi and sick building syndrome. Occup. Environ. Med. 1998, 55, 579584.
5. Burge, H. Bioaerosols: Prevalence and health effects in the indoor environment. J. Allergy Clin.
Immun. 1990, 86, 687701.
6. Dharmage, S.; Bailey, M.; Raven, J.; Abeyawickrama, K.; Cao, D.; Guest, D.; Rolland, J.;
Forbes, A.; Thien, F; Abramson, M.; et al. Mouldy houses influence symptoms of asthma among
atopic individuals. Clin. Exp. Allergy 2002, 32, 714720.
7. Jacobs, D.E. Housing-related health hazards: Assessment and remediation. Encyclopedia Environ.
Health 2011, 3, 7694.
8. Clean Air Society of Australia and New Zealand (CASANZ). Summary of Indoor Air Quality in
Australia: A Strategy for Action; FASTS Occasional Paper Series Number 5; CASANZ: Sydney,
Australia, 2002.
9. Hargreaves, M.; Parappukkaran, S.; Morawska, L.; Hitchins, J.; He, C.; Gilbert, D. A pilot
investigation into associations between indoor airborne fungal and non-biological particle
concentrations in residential houses in Brisbane, Australia. Sci. Total Environ. 2003, 312, 89101.
10. Li, C.S.; Hsu, C.W.; Tai, M.L. Indoor pollution and sick building syndrome symptoms among
workers in day-care centers. Arch. Environ. Health 1997, 52, 200207.
11. World Health Organisation Europe. WHO Guidelines for Indoor Air Quality: Dampness and
Mould. Available online: http://www.euro.who.int/en/home (accessed on 16 April 2015).
12. Chakravarty, P.; Kovar, B. Evaluation of five antifungal agents used in remediation practices
against six common indoor fungal species. J. Occup. Environ. Hyg. 2013, 10, 1116.

Int. J. Environ. Res. Public Health 2015, 12

6331

13. Morey, P.R. Mold remediation in North American buildings. In Fundamentals of Mold Growth in
Indoor Environments and Strategies for Healthy Living; Wageningen Academic Publishers:
Gelderland, the Netherlands, 2011; pp. 383411.
14. Kemp, P.; Neumeister, K.H. Australian Mould Guidelines. Available online: http://inspectapedia.com/
sickhouse/Australian_Mold_Guideline-2005.pdf (accessed on 16 April 2015).
15. Sholberg, P.L.; Haag, P.; Hocking, R.; Bedford, K. The use of vinegar vapor to reduce
post-harvest decay of harvested fruit. Hortic. Sci. 2000, 35, 898903.
16. Tzortzakis, N.G. Ethanol, vinegar and Origanum vulgare oil vapour suppress the development of
anthracnose rot in tomato fruit. Int. J. Food Microbiol. 2010, 142, 1418.
17. Hammer, K.A.; Carson, C.F.; Riley, T.V. In vitro activity of Melaleuca alternifolia (tea tree) oil
against dermatophytes and other filamentous fungi. J. Antimicrob. Chemoth. 2002, 50, 195199.
18. Carson, C.F.; Hammer, K.A.; Riley, T.V. Melaleuca alternifolia (tea tree) oil: A review of
antimicrobial and other medicinal properties. Clin. Microbiol. Rev. 2006, 19, 5062.
19. Usachev, E.V.; Pyankov, O.V.; Usacheva, O.V.; Agranovski, I.E. Antiviral activity of tea tree and
eucalyptus oil aerosol and vapour. J. Aerosol Sci. 2012, 59, 2230.
20. Huang, R.; Oleg V.P.; Yu, B.; Agranovski, I.E. Inactivation of fungal spores collected on fibrous
filters by Melaleuca alternifolia (tea tree oil). Aerosol Sci. Technol. 2010, 44, 262268.
21. NIOSH Method 0800: Bioaerosol sampling (Indoor Air). NIOSH Manual of Analytical Methods
(NMAM), 1998. Available online: http://www.cdc.gov/niosh/docs/2003-154/pdfs/0800.pdf
(accessed on 16 April 2015).
22. Latg, J.P. Aspergillus fumigatus and Aspergillosis. Clin. Microbiol. Rev. 1999, 12, 310350.
23. Andersen, B.; Frisvad, J.C.; Sndergaard, I.; Rasmussen, I.S.; Larsen, L.S. Associations between
fungal species and water damaged building materials. Appl. Environ. Microbiol. 2011, 77, 41804188.
24. Ficker, C.E.; Amason, J.T.; Vindas, L.P.; Akpagana, K.; Gbeassor, M.; Souza, C.D.; Smith, M.L.
Inhibition of human pathogenic fungi by ethnobotanically selected plant extracts. Mycoses 2003,
46, 2937.
25. Soylu, E.M.; Kurt, S.; Soylu, S. In vitro and in vivo antifungal activities of the essential oils of
various plants against tomato grey mould disease agent Botrytis cinerea. Int. J. Food Microbiol.
2010, 143, 183189.
26. Tortorano, A.M.; Viviani, M.A.; Biraghi, E. In vitro testing of fungicidal activity of biocides
against Aspergillus fumigatus. J. Med. Microbiol. 2005, 54, 955957.
27. Hernandez, A.; Martro, E.; Matas, L.; Martin, M.; Ausina, V. Assessment of in-vitro efficacy of
1% Virkon against bacteria, fungi, viruses and spores by means of AFNOR guidelines. J. Hosp.
Infect. 2000, 46, 203209.
28. Griffiths, P.A.; Babb, J.R.; Fraise, A.P. Mycobactericidal activity of selected disinfectants using a
quantitative suspension test. J. Hosp. Infect. 1999, 41, 111121.
29. Broadley, S.J.; Furr, J.R.; Jenkins, P.A.; Russell, A.D. Antimycobacterial activity of Virkon.
J. Hosp. Infect. 1993, 23, 189l 97.
30. Coates, D.; Wilson, M. Powders composed of chlorine-releasing agent acrylic resin mixtures or
based on peroxygen compounds for spills of body fluids. J. Hosp. Infect. 1992, 21, 241252.

Int. J. Environ. Res. Public Health 2015, 12

6332

31. Attaway, H.H.; Fairey, S.F.; Steed, L.L.; Salgado, C.D.; Michels, H.T.; Schmidt, M.G.
Intrinsic bacterial burden associated with intensive care unit hospital beds: Effects of disinfection
on population recovery and mitigation of potential infection risk. Am. J. Infect. Control 2012, 40,
907912.
32. Sagripanti, J.L.; Bonifacino, A. Resistance of Pseudomonas aeruginosa to liquid disinfectants on
contaminated surfaces before formation of biofilms. J. AOAC Int. 2000, 83, 14151422.
33. Jin, T.; We, Y.; Qang, Q. The inhibitory effects of bamboo vinegar against bacteria and fungi.
Inf. Technol. Agric. Eng. 2012, 134, 451457.
34. McDonnell, G.; Russell, A.D. Antiseptics and disinfectants: Activity, action, and resistance.
Clin. Microbiol. Rev. 1999, 12, 147179.
35. Legan, J.D. Mould spoilage of bread: The problem and some solutions. Int. Biodeter. Biodegr.
1993, 32, 3353.
36. Karabulut, O.A.; Romanazzi, G.; Smilanick, J.L.; Lichter, A. Postharvest ethanol and potassium
sorbate treatments of table grapes to control gray mold. Postharvest Biol. Tec. 2005, 37, 129134.
37. Dantigny, P.; Guilmart, A.; Radoi, F.; Bensoussan, M.; Zwietering, M. Modelling the effect of
ethanol on growth rate of food spoilage moulds. Int. J. Food Microbiol. 2005, 98, 261269.
38. Dao, T.; Bensoussan, M.; Gervais, P.; Dantigny, P. Inactivation of conidia of
Penicillium chrysogenum, P. digitatum and P. italicum by ethanol solutions and vapours.
Int. J. Food Microbiol. 2008, 122, 6873.
39. Cox, S.D.; Mann, C.M.; Markham, J.L.; Bell, H.C.; Gustafson, J.E.; Warmington, J.R.;
Wyllie, S.G. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia
(tea tree oil). J. Appl. Microbiol. 2000, 88, 170175.
40. Szczerbanik, M.; Jobling, J.; Morris, S.; Holford, P. Essential oil vapours control some common
postharvest fungal pathogens. Aust. J. Exp. Agr. 2007, 47, 103109.
41. Shao, X.; Cheng, S.; Wang, H.; Yu, D.; Mungai, C. The possible mechanism of antifungal action
of tea tree oil on Botrytis cinerea. J. Appl. Microbiol. 2013, 114, 16421649.
42. Su, H.J.; Chao C.J.; Chang, H.Y.; Wu, P.C. The effects of evaporating essential oils on indoor air
quality. Atmos. Environ. 2007, 41, 12301236.
43. Inouye, S.; Tsuruoka, T.; Watanabe, M.; Takeo, K.; Akao, M.; Nishiyama, Y.; Yamaguchi, H.
Inhibitory effect of essential oils on apical growth of Aspergillus fumigatus by vapour contact.
Mycoses 2000, 43, 1723.
44. Inouye, S.; Watanabe, M.; Nishiyama, Y.; Takeo, K.; Akao, M.; Yamaguchi, H. Anti-sporulating
and respirational inhibitory effects of essential oils on filamentous fungi. Mycoses 1998, 41,
403410.
45. Reynolds, K.A.; Boone, S.; Bright, K.R.; Gerba, C.P. Occurrence of household mold and efficacy
of sodium hypochlorite disinfectant. J. Occup. Environ. Hyg. 2012, 9, 663669.
46. Andrews, S. Evaluation of surface disinfection procedures for enumerating fungi in foods:
A collaborative study. Int. J. Food Microbiol. 1996, 29, 177184.
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